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John Williamson (), more commonly known by the nickname Johnnie Notions (, ) was a self-taught
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
from
Shetland Shetland, also called the Shetland Islands and formerly Zetland, is a subarctic archipelago in Scotland lying between Orkney, the Faroe Islands and Norway. It is the northernmost region of the United Kingdom. The islands lie about to the no ...
, Scotland, who independently developed and administered an
inoculation Inoculation is the act of implanting a pathogen or other microorganism. It may refer to methods of artificially inducing immunity against various infectious diseases, or it may be used to describe the spreading of disease, as in "self-inoculati ...
for
smallpox Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) c ...
to thousands of patients in Shetland during the late 18th century. Despite having only an elementary education and no formal medical background, the treatment he devised had an extremely high success rate, resulting in the immunisation of approximately 3,000 people and the saving of many lives, which had a significant effect on the demographics of the Shetland population at the time. He is reputed not to have lost a single patient. While Notions administered his inoculation by at least the late 1780s to early 1790s (and likely much earlier), his method was largely overshadowed by the work of
Edward Jenner Edward Jenner, (17 May 1749 – 26 January 1823) was a British physician and scientist who pioneered the concept of vaccines, and created the smallpox vaccine, the world's first vaccine. The terms ''vaccine'' and ''vaccination'' are derived f ...
, who pioneered the
cowpox Cowpox is an infectious disease caused by the ''cowpox virus'' (CPXV). It presents with large blisters in the skin, a fever and swollen glands, historically typically following contact with an infected cow, though in the last several decades more ...
-based
smallpox vaccine The smallpox vaccine is the first vaccine to be developed against a contagious disease. In 1796, British physician Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox ...
in 1796. Despite this, Notions and his inoculation were held with high regard with Shetlanders at the time, while the same could not be said for the cowpox-based vaccination introduced to Shetland in subsequent years.


Early life

John Williamson was born the son of Andrew Williamson; his mother's name is unknown. It has been suggested that the practice of naming John by his father's own surname, not adopting the
patronymic A patronymic, or patronym, is a component of a personal name based on the given name of one's father, grandfather (avonymic), or an earlier male ancestor. Patronymics are still in use, including mandatory use, in many countries worldwide, alt ...
s system that was prevalent in Shetland at that time, indicates that his immediate family could be considered progressive and modern for the time. John Williamson's birth year is not known with any certainty – while his tombstone states he was born in 1740, some have suggested he was born as early as 1730. His place of birth is also not certain, but is thought to be Hamnavoe,
Eshaness Esha Ness, also spelled Eshaness, is a peninsula on the west coast of Northmavine, on the island of Mainland, Shetland, Scotland. Esha Ness Lighthouse on the west coast, just south of Calder's Geo. It was designed by David Alan Stevenson and c ...
, in which the Williamson family lived from at least the late 1740s and possibly much earlier.


Smallpox inoculation


Background

Shetland, being a relatively isolated community, was susceptible to outbreaks of
smallpox Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) c ...
throughout the 18th century that would spread through large proportions of the population due to a lack of immunity to the disease. In 1700, an outbreak of smallpox arrived in Shetland when the son of a local man had visited mainland Britain, where he had contracted the disease and spread it upon his return to Shetland. An estimated one-third of Shetland's population died as the result of this epidemic. The disease was subsequently referred to as "mortal pox", while the 1700 outbreak was used by those born around this time as a reference to calculate their age. Some of the smaller islands of Shetland were particularly hard hit –
Fair Isle Fair Isle (; sco, Fair Isle; non, Friðarey; gd, Fara) is an island in Shetland, in northern Scotland. It lies about halfway between mainland Shetland and Orkney. It is known for its bird observatory and a traditional style of knitting. Th ...
had previously had between ten and twelve families, but is said to have lost two thirds of its population in the 1700 outbreak, leaving too few to effectively manage their fishing boats; in
Fetlar Fetlar ( sco, Fetlar) is one of the North Isles of Shetland, Scotland, with a usually resident population of 61 at the time of the 2011 census. Its main settlement is Houbie on the south coast, home to the Fetlar Interpretive Centre. Fetlar i ...
smallpox killed over 90 islanders of whom "most were married people". Smallpox would continue to strike Shetland every 20 years, with epidemics occurring in 1700, 1720, 1740 and 1760. The 1720 epidemic hit
Foula Foula (; sco, also Foola; nrn, Fuglø), located in the Shetland archipelago of Scotland, is one of the United Kingdom’s most remote permanently inhabited islands. Owned since the turn of the 20th century by the Holbourn family, the island wa ...
particularly hard, where it is said "there were scarcely people left to bury the dead", whereas in Fetlar a certain amount of resistance is thought to have built up, as most of the 80 who died were under the age of 20. The 1740 epidemic required the extension of the
Lerwick Lerwick (; non, Leirvik; nrn, Larvik) is the main town and port of the Shetland archipelago, Scotland. Shetland's only burgh, Lerwick had a population of about 7,000 residents in 2010. Centred off the north coast of the Scottish mainland ...
cemetery by , while in Fetlar a further 120 people died – this was exacerbated by a hard frost lasting over a month that prevented the dead from being buried. Approximately one-third of
Unst Unst (; sco, Unst; nrn, Ønst) is one of the North Isles of the Shetland Islands, Scotland. It is the northernmost of the inhabited British Isles and is the third-largest island in Shetland after Mainland and Yell. It has an area of . Unst ...
's population was killed by smallpox. It is likely that Notions himself caught smallpox as a child of about ten during this epidemic.


Technique

Notions would first collect "matter" – i.e., smallpox
pus Pus is an exudate, typically white-yellow, yellow, or yellow-brown, formed at the site of inflammation during bacterial or fungal infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection ...
. He would then dry it using
peat Peat (), also known as turf (), is an accumulation of partially decayed vegetation or organic matter. It is unique to natural areas called peatlands, bogs, mires, moors, or muskegs. The peatland ecosystem covers and is the most efficien ...
smoke (which was believed to lessen the virus's virulence), and bury it in the ground with
camphor Camphor () is a waxy, colorless solid with a strong aroma. It is classified as a terpenoid and a cyclic ketone. It is found in the wood of the camphor laurel ('' Cinnamomum camphora''), a large evergreen tree found in East Asia; and in the k ...
(which has anti-bacterial properties, preventing the matter from decomposing). Oral history indicates the matter was spread between
glass Glass is a non-crystalline, often transparent, amorphous solid that has widespread practical, technological, and decorative use in, for example, window panes, tableware, and optics. Glass is most often formed by rapid cooling (quenching) of ...
sheets before burial. It would be kept in this state for up to 7 or 8 years to reduce its
virulence Virulence is a pathogen's or microorganism's ability to cause damage to a host. In most, especially in animal systems, virulence refers to the degree of damage caused by a microbe to its host. The pathogenicity of an organism—its ability to ca ...
before being administered to a patient. By using a knife (which Notions made himself) he would cut into the patient's arm intradermally (without drawing blood), insert a small amount of the inoculant, and immediately cover the incision with the patient's skin, before using a cabbage leaf as a plaster. In contrast to contemporaneous
quack doctors Quack, The Quack or Quacks may refer to: People * Quack Davis, American baseball player * Hendrick Peter Godfried Quack (1834–1917), Dutch economist and historian * Joachim Friedrich Quack (born 1966), German Egyptologist * Johannes Quack ( ...
, Notions would not stipulate any particular resting conditions (such as "hot-treatment" – heating the ill patient in front of a fire, covering them with blankets and allowing them no fresh-air), nor would he administer any other medicines during the period of infection and recovery. Notions' inoculation bears a strong similarity to the Suttonian method, which also involved the introduction of weakened smallpox matter into the patient through intradermal means. How Notions became aware of this method of inoculation is unclear – it may have been through written account, or through discussion with someone else aware of the technique, such as another physician or a member of the clergy.


Results

It is not known whether the success of the inoculation technique used by Notions was due to its ability to decrease the virulence of the smallpox matter, or to the shallow intradermal insertion of the inoculant. The technique was highly successful and it and Notions was highly esteemed in Shetland. Notions was revered in contemporary accounts for the work he did. Reverend Andrew Dishington, the parish minister for Mid and South
Yell A yell is a loud vocalization; see screaming. Yell may also refer to: Places United Kingdom * Yell, Shetland, one of the North Isles of the Shetland archipelago, Scotland * Yell Sound, Shetland, Scotland United States * Yell, Tennessee, an unin ...
, attested to the success of Notions' treatment:
Unassisted by education, and unfettered by the rules of art, he stands unrivalled in this business. Several thousands have been inoculated by him, and he has not lost a single patient. ...It is particularly remarkable, that there is not a single instance in his practice, where the infection has not taken place, and made its appearance at the usual time.
In Arthur Edmondston's account, he commented that Notions' work:
...met with such unexampled success in his practice, that were I not able to bear testimony to its truth, I should myself be disposed to be sceptical on the subject. ...Had every practitioner been as uniformly successful in the disease as he was, the small-pox might have been banished from the face of the earth, without injuring the system, or leaving any doubt as to the fact.
Oral history recounts that Notions was able to save 16 of the 24 remaining inhabitants of
Foula Foula (; sco, also Foola; nrn, Fuglø), located in the Shetland archipelago of Scotland, is one of the United Kingdom’s most remote permanently inhabited islands. Owned since the turn of the 20th century by the Holbourn family, the island wa ...
after an epidemic of smallpox struck there, and that he was "greatly honoured" for having saved their lives. It is not clear how many patients of Notions may have contracted secondary infections following inoculation. Also, it is possible that Notions' treatment may have caused some patients such as Lowrie Tulloch of
Burravoe Burravoe is a community on the north shore of Burra Voe, in the south-east part of the island of Yell in the Shetland Islands, Scotland. The name Burravoe is derived from the Old Norse ''Borgavágr'', meaning ''broch bay''. The most notable ...
, Yell, or James Park of Fetlar to have been blinded. Notions is believed to have saved many more lives than he caused harm to.


Other occupations

Notions was considered someone who could apply his manual skills to many different trades and crafts. He was described during his lifetime as "a singular instance of an uncommon variety of talents, being a tailor, a joiner, a clock and watch-mender, a blacksmith, and a physician". He was additionally attributed with being (at various periods throughout his life) a farmer, fisherman, and weaver. Archivist Brian Smith at the Shetland Museum and Archives recounts how he is said to have been assigned the nickname "Notions", which he was called by his contemporaries:
... he name "Notions"was bestowed on him by a member of the Gifford family. According to this story, Williamson was at Gifford's house, presumably on business, and the landlord asked him to rid his house of 'checks', small noisy
wood-boring beetles The term woodboring beetle encompasses many species and families of beetles whose larval or adult forms eat and destroy wood (i.e., are xylophagous). In the woodworking industry, larval stages of some are sometimes referred to as woodworms. The t ...
. Williamson looked behind the clock and cleared away a mass of creepy crawlies. 'You hear no more checks now,' he said. Gifford replied, fatuously, 'What a notions!'
Notions is also said to have constructed a complex functional miniature watermill, which was based on a mill which he had only viewed a single time. It was capable of performing the same function of
bleaching Bleach is the generic name for any chemical product that is used industrially or domestically to remove color (whitening) from a fabric or fiber or to clean or to remove stains in a process called bleaching. It often refers specifically, to ...
as the original mill through the power of a hand-turned crank. The only known remaining work of Notions is a wig stretching block that was made for James Cheyne, 7th Laird of Tangwick (the great-grandfather of Sir William Watson Cheyne), who was the laird of the area around
Eshaness Esha Ness, also spelled Eshaness, is a peninsula on the west coast of Northmavine, on the island of Mainland, Shetland, Scotland. Esha Ness Lighthouse on the west coast, just south of Calder's Geo. It was designed by David Alan Stevenson and c ...
. The block is said to have been made in the image of a man from
Hillswick Hillswick is a small village in Northmavine, on the shore of the Atlantic Ocean and lies to the north-north west of Mainland, Shetland, the most northerly group of islands in the United Kingdom. It is situated from Lerwick. There is a community ...
who contracted smallpox and was treated by Notions. It is made from a worm-eaten piece of wood, the holes of which were filled with smaller pieces of wood to portray the smallpox scars on the man's face. The wig block is now kept in the Shetland Museum.


Johnnie Notions' Böd

An outbuilding near to the site of Johnnie Notions' house in Hamnavoe, Eshaness is () offered as a "camping böd" (böd being the
Shetland dialect Shetland dialect (also variously known as Shetlandic; broad or auld Shetland or Shaetlan; and referred to as Modern Shetlandic Scots (MSS) by some linguists) is a dialect of Insular Scots spoken in Shetland, an archipelago to the north of mainl ...
word for a fisherman's lodgings or store) which is rented out by the
Shetland Amenity Trust The Shetland Amenity Trust is a charitable trust based in Shetland, Scotland. It was formed in 1983. Among the Trust's aims are to preserve and protect the architectural heritage of Shetland and it owns and operates many historical buildings. ...
as basic accommodation with limited facilities in the style of a camping barn. Johnnie Notions' Böd does not have an electricity supply, for example. The böd is open from 1 April to 31 October. Notions' original house and its outbuildings were designated as a Category C
listed building In the United Kingdom, a listed building or listed structure is one that has been placed on one of the four statutory lists maintained by Historic England in England, Historic Environment Scotland in Scotland, in Wales, and the Northern Irel ...
in 1978.


Notes


References


Sources

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External links


Find a Grave
– Details of new tombstone at Cross Kirk Cemetery, Eshaness
Shetland Camping Böds
– Johnnie Notions' Böd as accommodation
Shetland Museum & Archives
– Image of wig stretcher made by Johnnie Notions {{DEFAULTSORT:Notions, Johnnie History of Shetland Smallpox vaccines Smallpox eradication People from Shetland 18th-century Scottish medical doctors History of medicine in the United Kingdom 18th century in Shetland Northmavine